Individual
KELLY ANN BARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2526 NE 15TH AVE, PORTLAND, OR 97212-4222
(503) 288-7668
Mailing address
525 SE 46TH AVE, PORTLAND, OR 97215-1701
(609) 332-5059
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18707
OR
Other
Enumeration date
09/15/2013
Last updated
09/15/2013
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